To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Rescind Prior Board Action Pertaining to a Payment for Services for iRhythm Technologies, Inc.
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
RESCIND Board action of November 18, 2025 (C.63), which pertained to a Payment for Services to pay $330,300 to iRhythm Technologies, Inc.; and APPROVE and AUTHORIZE the Auditor-Controller, or designee, to pay $342,900 to iRhythm Technologies, Inc., for remote cardiac monitoring services provided to patients at Contra Costa Regional Medical Center (CCRMC) and Contra Costa Health Centers, for the period March 1, 2024 through October 31, 2025, as recommended by the Health Services Director.
FISCAL IMPACT:
Approval of this payment will result in a one-time expenditure of up to $342,900 and will be funded 100% by Hospital Enterprise Fund I revenues.
BACKGROUND:
Due to the limited number of specialty providers available within the community, CCRMC and Contra Costa Health Centers rely on contracts to provide necessary specialty health services to its patients. iRhythm Technologies. Inc. has the only Food and Drug Administration (FDA) approved artificial intelligence (Al) algorithm across all cardiac arrhythmia classes and is user friendly. The Zio Patch cardiac monitoring device can quickly and accurately read 1.5 million heart beats per patient record, at the same accuracy as a panel of human experts. The Zio patch cardiac monitoring device is the only wearable patch on the market that can be placed on a patient's chest for up to 14 days uninterrupted. All other products require multiple patient manipulations that lead to insufficient data and delays in diagnosis.
This Contract is entered into under and subject to the following legal authorities: California Government Code § 26227 and 31000. This contract was approved by Health Services Personnel to ensure there is no conflict with labor relations. Contractor is a Sole Source provider and was approved by the Public Works Department’s Purchasing Division on September 25, 2023, for their expertise in cardiac monitoring services.
On October 17, 2023, the Board of Supervisors approved Contract #76-830 with iRhythm Technologies, Inc., in an amount not to exceed $800,000, to provide remote cardiac monitoring services for patients at CCRMC and Contra Costa Health Centers, for the period November 1, 2023 through October 31, 2025.
Due to an increase in remote cardiac monitoring services needed by CCRMC, additional services were requested by the County, however due to an administrative error, additional invoices were missed, which exceeded the original payment limit by $342,900. Contractor continued to provide these services in good faith, therefore, the County has determined that with iRhythm Technologies, Inc., is entitled to payment for the reasonable value of their services under the equitable relief theory of quantum meruit. That theory provides that where a person has been asked to provide services without a valid contract, and the provider does so to the benefit of the recipient, the provider is entitled to recover the reasonable value of those services. As such, the Department recommends that the Board authorize the Auditor-Controller to issue a one-time payment not to exceed $342,900 to with iRhythm Technologies, Inc.
On November 18, 2025, (C.63), the Board of Supervisors approved the Auditor-Controller, or designee, to pay an amount not to exceed $330,300 to iRhythm Technologies, Inc., however the amount was incorrect.
This Board order will rescind the incorrect Board action and allow the Auditor-Controller, or designee to issue a one-time payment for the correct amount not to exceed $342,900 to iRhythm Technologies, Inc., for the period March 1, 2024 through October 31, 2025.
CONSEQUENCE OF NEGATIVE ACTION:
If this Board action is not approved, the Contractor will not be paid the correct amount for services requested by CCRMC and provided by Contractor in good faith.